肩峰下脂肪垫的断层解剖与MRI观测及临床意义

目的　为肩峰撞击征的诊断和治疗提供断层解剖学基础。 方法　（1）取15例女性标本进行肩关节的断层切割观察；(2)运用MRI技术对10例女性健康人的肩峰下脂肪垫进行测量。 结果　（1）肩峰下脂肪垫上方为斜方肌,下方为冈上肌，在肩峰下面与肩峰下三角肌滑膜囊相邻，在横断面上呈方形，在斜矢状断面和斜冠状断面上呈长条形；肩峰下脂肪垫长度为（48.91±7.5）mm, 宽度为（28.0±4.7）mm,肩峰下脂肪垫厚度在冈上肌中部为（11.5±1.9）mm，在肩峰外缘为（3.1±0.8）mm。（2）MRI轴位、斜矢状位、斜冠状位可清楚显示肩峰下脂肪垫,肩峰下脂肪垫长度（49.8±7.0）mm, 宽度为(28.7±5.2)mm,肩峰下脂肪垫厚度在冈上肌中部为(12.5±1.5)mm，在肩峰外缘为(3.2±0.8)mm。（3）断层肩峰下脂肪垫长度、宽度、厚度观测值数据和MRI数据分别进行t检验结果无差异(P>0.05)。 结论　MRI的肩峰下脂肪垫测量可以为肩峰撞击症早期诊断提供解剖学依据。

The observation and clinical significance of subacromial fat pad based on sectional dissection and magnetic resonance imaging (MRI) technology

Objective　To offer the data for diagnosis and treatment of impingement of acromion. Methods (1) the shoulder joints from fifteen female specimens were used for sectional dissection ;(2) subacromial fat pad from ten female specimens were observed by MRI technology. Results (1) The subacromial fat pad was adjacent to deltoid bursa at subacromial region; the trapezius muscle was supeior to it, while the supraspinatus is inferior to it. It was square in cross section and is narrowly elongated in the oblique sagittal section and coronal section;the length and width of the subacromial fat pad is (48.91±7.5)mm and (28±4.7) mm, respectively. The thickness was (11.5±1.9 )mm in the central supraspinatus and ( 3.1±0.8)mm at acromial margin.(2)The subacromial fat pad could be clearly displayed by MRI in transverse, oblique sagittal, oblique coronal planes.The length of subacromial fat pad is (49.8±7.0)mm and the width is( 28.7±5.2)mm; the thickness is (12.5±1.5)mm at the central supraspinatus and (3.2±0.8)mm at acromial margin. (3) The data from direct anatomical observation and MRI observation of sectional subacromial fat pad showed no differences (P>0.05) in the length, width and thickness, respectively. Conclusion The measurement of the subacromial fat pad detected by MRI can provide an early diagnosis for acromial impingement syndrome.